title: Barriers to Garden Visitation in Children's Hospitals.
abstract: OBJECTIVE
  This study aimed to identify barriers to use of outdoor spaces in Texas pediatric healthcare facilities.
  
  
  BACKGROUND
  Available research on hospital healing gardens and outdoor spaces has indicated that despite several health benefits of garden visitation for staff, patients, and family members, these amenities are not being used to their fullest capacity. Previous researchers have recommended design features such as comfortable seats and adequate shade to increase garden visitation in healthcare setting. However no quantitative data have demonstrated significance of correlation between presence of these design features and garden use. The present study served to statistically support design guidelines suggested by previous researchers and introduce new guidelines.
  
  
  METHODS
  Site visits and surveys were conducted in five green outdoor spaces in three pediatric hospitals in east Texas. Hospital visitors, family members, and staff responded to questions concerning barriers to garden visitation, their visitation habits, and satisfaction with the garden features. The study was reviewed and approved by Institutional Review Boards of the relevant hospitals and academic institutions.
  
  
  RESULTS
  A negative significant correlation was found between staff garden use and dissatisfaction with quality of seats and poor shade. While quality of seats didn't impact visitor and family member garden visitation, a significant negative correlation was found between poor shade and their garden use.
  
  
  CONCLUSIONS
  The study served to statistically support previous design suggestions for hospital gardens, and introduced new design guidelines. Design recommendations include functionality, visibility, accessibility, exclusivity, and availability of shade and seats.
  
  
  BACKGROUND
  Design process, evidence-based design, healing environments, hospital.
authors.affiliation: CORRESPONDING AUTHOR: Samira Pasha, HOK, 3223 Grace St. NW, Washington, DC 20007; samira.pasha@HOK.com.
authors.forename: Samira
authors.initials: S
authors.lastname: Pasha
mesh_terms: D005190:Family; D051639:Gardening; D006776:Hospitals, Pediatric; D006801:Humans; D011795:Surveys and Questionnaires; D013781:Texas